Step II Unexpectedly large drop Step 1 -> Step 2

[Shnazaholic]

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Hey all. I'm a US MD from a mid-low tier school. I got my scores back and was shocked by an unexpected score drop from step 1. I'm planning to apply IM and I was hoping to get back to the west coast and I don't plan on applying to academic programs. I just want to know how much I should adjust my expectations or how screwed am I.

Step 1: 248
UWSA 1: 243
UWSA 2: 251
Free 120: 70%
Step 2: 231
IM & FM shelf exams: 69th percentile
All other shelf exams: 30-40th percentiles